Underlying disease is the main risk factor in post‐splenectomy complication risk: Data from a national database
Year: 2025
Type: article
Study design: Observational Study
Abstract: Splenectomy is required for many haematological conditions and causes an increased risk of severe infections and vascular events. The association between underlying haematological disease, age at splenectomy and post-splenectomy complications was explored among 1348 splenectomized patients, followed with a median follow-up time of 13 years and affected by transfusion-dependent thalassaemia, non-transfusion-dependent thalassaemia (NTDT), sickle cell anaemia (SCA), congenital haemolytic anaemias, autoimmune haematological disorders and trauma. Our main statistical approach was based on interaction analyses within competing-risk survival models. The baseline risk profile differed across diagnostic categories, with SCA being particularly susceptible to infectious complications and NTDT and SCA to vascular events (p < 0.001). The age at splenectomy did not impact on infectious risk but rather older age at splenectomy was associated with increased risk for vascular complications. Furthermore, the risk of developing a post-splenectomy complication was persistent throughout the observation period and not limited to the first 2-3 years after splenectomy. The probability of a post-splenectomy complication was highly dependent on the underlying disease and not on the age at splenectomy, so the indications for splenectomy must be based on careful assessment of pros and cons in the individual disease, with no need to delay surgery after a certain age when clinically indicated.
Source: British Journal of Haematology
DOI: 10.1111/bjh.20114
Authors: Maddalena Casale, Raffaella Colombatti, Manuela Balocco, Paola Corti, Susanna Barella, Giovanna Graziadei, Loredana Farinasso, Tommaso Mina, Simone Cesaro, Tommaso Casini, Fiorina Giona, Saverio Ladogana, Pellegrina Pugliese, Lucia Dora Notarangelo, Antonella Sau, Simone Ferrero, Giovanni Palazzi, Giovanna Russo, Ilaria Lazzareschi, Marilena Serra, Saveria Campisi, Gianluca Boscarol, Elena Facchini, Carlo Baronci, Maria Caterina Putti, Domenico Roberti, Marzia Manilia, Antonio Ivan Lazzarino, Gian Luca Forni, Silverio Perrotta, the Italian Network of Asplenia
Institutions: University of Campania "Luigi Vanvitelli", University of Padua, Azienda Ospedale - Università Padova, Ente Ospedaliero Ospedali Galliera, Azienda Ospedaliera San Gerardo, Ospedale Microcitemico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Policlinico San Matteo Fondazione, Azienda Ospedaliera Universitaria Integrata Verona, Meyer Children's Hospital, Sapienza University of Rome, Casa Sollievo della Sofferenza, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Turin, Azienda Ospedaliero-Universitaria di Modena, University of Catania, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Vito Fazzi, Ospedale di Bolzano, Bambino Gesù Children's Hospital
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
Funder: American Society of Hematology
OpenAlex ID: W4409953633